California Organized Investment Network (COIN) Is a Collaborative Effort Between the California Department of Insurance, the Insurance Industry, Community Affordable Housing and Economic Development Organizations, and Community Advocates.

The Investigation Division investigates suspected fraud committed by insurance agents, brokers, public adjusters, bail agents, insurance companies and other individuals and entities transacting the business of insurance who perpetrate fraud against consumers.

Earthquake Probable Maximum Loss Questionnaire 2011

CA Earthquake Liability Questionnaire Forms and Instructions

The following form and filing instruction of the California Earthquake Liability Questionnaire as of December 31, 2011, are now available in Microsoft Excel and Adobe's Portable Document Format (PDF). The Excel document may be downloaded to your computer. For the documents in PDF format, you will need Adobe Acrobat Reader 3.0 or higher to view it or download a copy of the software by visiting our Free Document Readers page.

For companies that have data to report on Form A or Form B, we ask that you download the Excel files of the forms. If you have any problems downloading the files, please feel free to call my staff at (213) 346-6731. Fill out the form using the downloaded file, and e-mail it to rsbeqpml@insurance.ca.gov. For the Signature Page, please have it signed and saved/scanned back to a pdf file. If you are unable to scan it back to a pdf, please mail it to:California Department of Insurance
Rate Specialist Bureau - 14th Floor
300 South Spring Street
Los Angeles, CA 90013

Earthquake Liability Questionnaire 2011

Please note that the printing of the FORM in both PDF and MS Word requires legal size paper.

For furthur assistance, please call the Rate Specialist Bureau at (213) 346-6556 or e-mail us at RSBeqpml@insurance.ca.gov. Please include your name, company name, telephone number, and e-mail address in all correspondence with the CDI.